Inspection on 28/09/07 for Nowell Cottage

This inspection was carried out on 28th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Nowell Cottage 07/08/06

Nowell Cottage 24/01/06

Nowell Cottage 10/08/05

Nowell Cottage 07/03/05

Nowell Cottage 06/07/04

Nowell Cottage 27/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Nowell Cottage Aldington Road Lympne Hythe Kent CT21 4LH Lead Inspector Joseph Harris Key Unannounced Inspection 28th September 2007 5:30 Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nowell Cottage Address Aldington Road Lympne Hythe Kent CT21 4LH 01303 269879 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Charles Uden Mrs Roslyne Irene Joan Uden Vacant Mr David Charles Uden Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th August 2006 Brief Description of the Service: Nowell Cottage is a registered care home for 3 Service Users with a learning disability. It is the family home of Mr and Mrs Uden who are the registered providers. No other staff are employed. Family members offer additional support. The premises are situated on the edge of the village in a rural location surrounded by fields. There are other buildings on the site where the Registered Owners provide an activity workshop and a large summerhouse within the extensive, mature gardens. Mr and Mrs Uden’s stated aim is to provide a good quality of lifestyle within a rural family network where personal and life skill development are encouraged during the structured but flexible daily routines. The three Service Users have lived at the Home for more than 23 years. The reported weekly fees are £323.00. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection process culminated in an announced visit to Nowell Cottage on 28th September 2007. The visit lasted for approximately 3 hours. A number of attempts were made to conduct an unannounced inspection, but on each occasion there was no one present in the home. During the course of the site visit the inspector spent time with all of the service users and the proprietors. A tour of the premises was conducted and a range of records and documents were examined relating to the service users, health and safety and the day to day running of the business. The home returned the Annual Quality Assurance Assessment (AQAA) which was used to inform the inspection. What the service does well: What has improved since the last inspection? Work has continued to develop the premises and garden, which has been ongoing over the last 25 years. There are plans to convert one of the outbuildings and new paving has been laid. A new water feature has also recently been installed. The residents enjoyed a holiday in the spring to Butlins on the South-coast. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. The needs and aspirations of the service users are clearly understood. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home owners have provided care and support to the three current service users for approx 24 years. Nowell Cottage is their home and the service users live very much as part of the extended family. Continuing needs are monitored through daily life and routine and more formally by regular review. The needs and aspirations are well known and supported by the family. It is Mr and Mrs Uden’s stated intention not to take any more clients as and when vacancies arise. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. Resident’s needs and goals are met and decision-making is supported. Service users are able to take responsible risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plan documents are developed following liaison with Day centre staff and Care Management and are subject to regular review. The vast majority of activities are undertaken by the service users within or outside the home with the direct supervision of the providers or Day centre staff. It was noted that, where risk is perceived, appropriate actions are discussed with the care manager and the steps taken to manage the risk noted in the individual’s case notes. Service users are encouraged to take part in any decision making process and their choices and preferences are respected. Any restrictions are placed only in the interests of safety following discussion with appropriate Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 10 professionals. Each resident has a financial appointee independent of the home. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Residents have a wide range of opportunities and take part in varied activities. A healthy and balanced diet is provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A range of activities and pastimes are made available to the residents such as attendance at a local day centre, evening clubs, day trips and relaxed activities at home. One resident said, “We keep very busy. We went to Butlins on holiday”. Weekends are for family activities around the house or visiting and helping at the Stables and swimming at one daughter’s house. One service user often chooses to go to the other daughter’s next door. Service users are supported to maintain family links wherever possible. Mr and Mrs Uden maintain contact with resident’s families. Visitors are welcomed Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 12 without restriction and may be received in the resident’s own rooms or in the communal areas. A phone is available for private use. It was reported that all three service users choose to take their main meal of the day in the evening together with Mr and Mrs Uden. There is no set menu as Service Users decide daily what they wish to eat. Mrs Uden prepares meals dependent on individual choices and provides well presented, nutritious home cooked food. One resident’s special dietary needs are catered for, as is time to complete the meal at his own pace. Records are maintained of the meals taken by Service Users. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Service users receive personal support in the way they prefer and healthcare needs are monitored and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owners have lived and worked with the residents for around 24 years and have a detailed understanding of each individual’s preferences with regard to personal care. It was evident, through discussion, that changing needs are monitored and any healthcare issues are appropriately referred. Records are maintained in respect of health and personal care needs. Residents have access to the full range of health and social care professionals. Medication is appropriately stored, administered and recorded. None of the service users are assessed as being able to self-medicate. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Resident’s views are listened to and acted upon and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Operating as a family home, the service users are able to freely express themselves and make their opinions known. The owners discuss daily issues with the residents and encourage them to express their opinions. Mr and Mrs Uden have stated that they have undertaken a Criminal Record Bureau check. There are no separate staff employed at the home. There is no separate written policy regarding protection of vulnerable people but the Registered Owners have obtained a copy of the local multi agency policy and procedures for the protection of vulnerable adults. Service users may raise issues with Mr and Mrs Uden and their family members. They may also approach Day Opportunities Centre staff to advocate on their behalf. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. The home is comfortable, safe and has been adapted to meet the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Nowell Cottage is on the outskirts of the village Lympne near Folkestone. There are extensive and well tended gardens with a number of outbuildings providing additional spaces such as a summer house and an arts and crafts room. The home is set over three floors and is attractively presented. The owners have, over the years, invested in the updating of the environment, which provides a good range of communal spaces and bedrooms that the service users are proud of. The home is kept clean and tidy, which is a group effort with everyone taking a role in the upkeep. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35. Quality in this outcome area is good. There are no staff employed at the home, thus a number of standards are not applicable. Mr and Mrs Uden have a good understanding of the service users’ needs and offer a consistent level of care within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mr and Mrs Uden have a good understanding of the service users’ needs and offer a consistent level of care within the home. They liaise closely and regularly with other agencies and professionals to ensure the support they offer remains appropriate and relevant. They have completed CRB checks. The owners have completed mandatory training and update their knowledge in key areas as required. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. The service users benefit from a well run home. The health, safety and welfare of the residents is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Nowell Cottage is the family home of Mr and Mrs Uden who are the registered providers. No other staff are employed. The aim of the Home is to provide a family atmosphere and to consider and include the Service Users as part of the family. It is evident that the owners have continued to develop the premises and a currently planning to create an activities/party room in one of the outbuildings. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 18 The Annual Quality Assurance Assessment was also returned prior to the inspection process. From observation and from discussion with the service users they appear to be content with their life at Nowell Cottage and feel safe in their surroundings. Mr and Mrs Uden endeavour to ensure that measures are taken to promote the health, welfare and safety of everyone living at the Cottage. Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 N/A 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Nowell Cottage DS0000023233.V348435.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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